Nephrology Fellowship Training Program at Jackson Memorial Hospital Miami

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Nephrology Fellowship Training Program at Jackson Memorial Hospital Miami Welcome you to our facebook site. Check out our unofficial website:
http://renalmiami.pbworks.com. Regards,Oliver Lenz, MD MBA

11/05/2025

Worldwide, the number of people needing lifesaving kidney replacement therapy (KRT) steadily grows, but about two thirds of them lack access to KRT and thus die. Access to KRT depends on economic, social, infrastructural, ecological, and political factors. Current KRTs include kidney transplantation...

11/05/2025

Understanding how diabetes affects the kidneys and exploring new treatment options is of critical importance.

We present a special collection of articles on Diabetes and Kidney Disease: https://bit.ly/3wpQ6vg (FREE until July 1, 2025)

27/04/2025

🗝️ & GLP1RA not only lower blood sugar but also reduce cardiovascular events and improve outcomes in patients with , addressing a critical residual cardiovascular risk.

Dive deeper with expert insights ➡️ https://bit.ly/42LxpE9

14/04/2025

Dear colleagues, thank you for your hard work and care for our patients.

Our Nephrology fellowship at the University of Miami is growing!!! We have a new opening (from 5 to 6 fellows per year) and are seeking candidates to join our Nephrology fellowship program starting July 1, 2025. Our main goal is to provide comprehensive and balanced training. If you're interested, please reach out to me via private message. Thank you.

12/04/2025

Free Quiz from June 2024:

A 35-year-old female patient with end-stage kidney failure secondary to focal segmental glomerulosclerosis was initiated on continuous cyclic peritoneal dialysis (CCPD). The PD regimen comprised 5L of 2.5% tonicity dextrose and 5L of 1.5% dextrose, administered in 5 cycles of 2L over 10 hours followed by a long dwell of 2L icodextrin. Three years after PD initiation, she developed refractory Streptococcus agalactiae peritonitis requiring catheter removal and conversion to hemodialysis. Subsequently she decided to return to PD; hence 5 months later, a PD catheter was reinserted. After her return to PD, she had recurrent episodes of fluid overload. She had become anuric by her second year on PD. Her daily ultrafiltration before the episode of peritonitis was 1.5-2L. After return to PD, the daily ultrafiltration decreased to 700-900mL despite increasing dialysate tonicity on the cycler to all 2.5% dextrose. Ultrafiltration was mainly from the cycler, as she was retaining 200-300mL on icodextrin long dwell. Subsequently she received a mix of 4.25% and 2.5% dextrose, but ultrafiltration remained inadequate and she was eventually admitted a month later for fluid overload and hypertensive urgency requiring hemodialysis for volume control.
• What is the approach to a patient on peritoneal dialysis who presents with fluid overload?
• How is the modified peritoneal equilibration test performed and what information may it provide?
• What is the most likely diagnosis in this case and what would be the appropriate treatment?
https://bit.ly/3URN2FX

11/04/2025

Free Editorial by Azuma Nanamatsu and Kaice A. LaFavers:

Urinary tract infections (UTI) are a common infection that, if left untreated, can lead to complications such as pyelonephritis or sepsis. Patients with chronic kidney disease (CKD) are at increased risk of developing UTIs, particularly those patients who require long-term hemodialysis. In this issue of AJKD, Liyanarachi et al propose that some of the excess UTI risk found in patients with CKD could be associated with decreased urinary uromodulin. Uromodulin (also known as Tamm-Horsfall protein or THP) is made exclusively by the kidney and secreted apically from the thick ascending limb of the loop of Henle, where it passes through the distal tubules and makes its way into the urine. A smaller, but significant, portion is secreted basolaterally into the kidney interstitium, where it makes its way into the circulation. Multiple converging lines of evidence, described in more detail below, have suggested that uromodulin is protective in the setting of UTIs and Liyanarachi et al propose that this protection is lost in CKD, as both urinary and circulating uromodulin have been previously demonstrated to decrease in CKD.
https://bit.ly/NanamatsuEd25

09/04/2025

Despite substantial growth in the population of older adults with kidney disease, there remains a lack of evidence to guide clinical care for this group. The Kidney Disease and Aging Research Collaborative (KDARC) conducted a Delphi study to build consensus on research priorities for clinical geriatric nephrology. Experts in geriatric nephrology identified clinical research priorities with the greatest potential to improve care for older adults with kidney disease. These findings by Butler et al provide a roadmap for the geriatric nephrology community to harmonize and maximize the impact of research effort.
https://bit.ly/OIMcAdamsDeMarco24

08/02/2025

Open Access: Current guidance recommends against the use of metformin in people with advanced kidney impairment despite a lack of evidence. It is therefore currently unclear how the decision to stop versus continue metformin in patients who reach stage 4 CKD impacts their risk of mortality and cardiovascular events. This study by Lambourg et al showed that stopping metformin after reaching stage 4 CKD was associated with reduced survival that did not appear to be mediated by an increase in adverse cardiovascular outcomes. These findings may support the continued use of metformin in patients with advanced kidney impairment, but further research is needed to confirm these observations.
https://bit.ly/3ZdrYxb

06/02/2025

Free Research Letter from Byfield et al: Nocturnal hypertension is prevalent in those with chronic kidney disease (CKD). However, the mechanisms for nocturnal hypertension in the CKD population remain under investigation and social determinants of health (SDoH), the “conditions in which people are born, grow, live, work, and age,” may play a role. SDoH can augment psychosocial stress which in turn can activate physiological pathways that contribute to hypertension. Chronic stressors enhance activation of the sympathetic nervous system, an important regulator of circadian cardiovascular variation and this excess activation could specifically predispose individuals with CKD to nocturnal hypertension and accelerate hypertension-induced target organ damage.
https://bit.ly/Byfield25RL

02/02/2025

Although potentially beneficial, kidney transplantation remains infrequent among older adults aged≥70 years with kidney failure. This study by Villain et al evaluated the potential to increase living kidney donation among older adults, including their medical suitability as well as willingness to donate. Among 2,069 community-dwelling older adults (median age 80 years), 5% to 6% had no exclusion to donation. Among these individuals, 11% to 12% remained suitable for donation during 8 years of follow-up. Most exclusions were not related to eGFR and albuminuria. Willingness to living donation was high (73%). These findings highlight the potential benefits from expanding the pool of transplantable kidneys through the use of living donation in older adults.
https://bit.ly/3NigCB1

14/01/2025

Free Editorial by Sylvia E. Rosas and Morgan Reid: The National Organ Transplant Act (NOTA), enacted in 1984, established the Organ Procurement and Transplantation Network to function as a national registry for matching organs with recipients, and a Scientific Registry to report on the status of organ transplant annually. The OPTN contractor has the critical responsibility of maintaining the national transplant waitlist, matching organ donors with recipients, managing the technology used by organ procurement and transplant professionals, and developing organ donation and transplantation policies. It is the role of the OPTN contractor to achieve transplant access equity for all people, increase organ utilization to maximize every selfless gift of organ donation, and optimize the efficiency of the system. The United Network for Organ Sharing (UNOS) has been the sole federal contractor to manage the OPTN since its inception four decades ago. However, there is a cry by many stakeholders to reform the national transplant system due to repeated reports of inequities in transplantation, rising numbers of procured organs that are not used for transplant, as well as reported cases of procedural issues that led to patient harm.
https://bit.ly/4hP4DJA

27/10/2024

(FREE) HIV-associated nephropathy with collapsing lesion characterized by segmental collapse of the glomerular tuft and hyperplasia of overlying visceral epithelial cells with cytoplasmic protein droplets (Jones silver stain).

https://bit.ly/2fQhhaW

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